Ten-year prognosis of stroke and risk factors for death in a Japanese community - The Hisayama Study
Ten-year prognosis of stroke and risk factors for death in a Japanese community - The Hisayama Study
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DOI：
10.1161/01.str.0000091845.14833.43
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发表时间：
2003-10-01
期刊：
影响因子：
8.3
通讯作者：
Iida, M
中科院分区：
文献类型：
--
作者：
Kiyohara, Y;Kubo, M;Iida, M
背景和目的：目前很少有关于卒中后死亡的长期预后和危险因素的基于人群的队列研究。我们研究了10年的预后，原因和危险因素中风后死亡在日本cohol.Methods -在一个队列的1621名受试者大于或等于40岁的26年随访，333例首次中风，并进行了前瞻性随访10年后发病。在这10年的随访期间，333名中风患者中有268人死亡。其中，239人（89.2%）进行了尸检。结果-死亡的风险是最大的第一年后，首次中风发作的男女（男性，40.3%;女性，43.7%）。此后，生存曲线逐渐下降，到10年随访结束时，男性死亡风险达到80.7%，女性为80.2%。脑出血（63.3%）或蛛网膜下腔出血（58.6%）患者的30天病死率明显高于脑梗死患者（9.0%）。第一次中风后死亡的风险是无中风受试者的两倍。最常见的死亡原因是第一年的指数中风。此后，首次脑卒中的影响逐渐减少，而复发性脑卒中的影响增加。多变量分析显示，年龄，较低的体重指数，出血性中风是显着的危险因素中风后death after stroke.Conclusions -我们的研究结果表明，首次中风后死亡的风险是高的，部分原因是日本出血性中风的比例较大，相对于西方国家的中风受害者。
Background and Purpose - There have been very few population-based cohort studies of long-term prognosis and risk factors for death after stroke. We examined the 10-year prognosis, causes, and risk factors of death after stroke in a Japanese cohort.Methods - During a 26-year follow-up of a cohort of 1621 subjects greater than or equal to 40 years of age, 333 subjects developed first-ever stroke and were prospectively followed up for 10 years after onset. During these 10-year follow-up periods, 268 of the 333 stroke patients died. Of those, 239 ( 89.2%) underwent autopsy.Results - The risk of death was greatest in the first year after first-stroke onset in both sexes ( men, 40.3%; women, 43.7%). Thereafter, the survival curves decreased gradually, and risk of death reached 80.7% for men and 80.2% for women by the end of the 10-year follow-up. The 30-day case fatality rate was substantially greater in patients with cerebral hemorrhage (63.3%) or subarachnoid hemorrhage (58.6%) than in patients with cerebral infarction (9.0%). The risk of dying after the first stroke was twice the risk for stroke-free subjects. The most common cause of death was the index stroke in the first year. Thereafter, the impact of the first stroke gradually decreased, while that of recurrent stroke increased. Multivariate analysis revealed that age, lower body mass index, and hemorrhagic stroke were significant risk factors for death after stroke.Conclusions - Our findings suggest that the risk of death after first-ever stroke is high, in part because of the larger proportion of hemorrhagic stroke in Japanese relative to stroke victims in Western countries.